What pain tells us about cancer.

aNYU Bluestone Center for Clinical Research, Department of Oral and Maxillofacial Surgery, School of Dentistry, New York University College of Dentistry, NY, USA bDepartment of Neuroscience and Physiology, School of Medicine, New York University College of Dentistry, NY, USA.

Abstract

Cancer pain sends a message. It is frightening to the patient. It heralds progression or recurrence to the oncologist. It is a biological readout of the cancer-nerve interaction for the scientist. Nerves have been considered bystanders within the cancer microenvironment. However, emerging information suggests that nerves are recruited and participate in the carcinogenic process. These newly formed fibers respond to mediators secreted by constituents of the cancer microenvironment. In this manner, these nerves serve as bellwethers and sensors embedded within the cancer. When we rigorously assess patients' cancer pain, we gain insight into the action of cancer. An enhanced understanding of cancer pain offers biological questions that if answered might not only provide relief from cancer pain but might also improve survival.